A condition which affects the hearts of young children is far more common today than even a decade ago, suggests research.

The incidence of Kawasaki disease has more than doubled between 1991 and 2000, according to researchers from Oxford University and Imperial College London.

It normally strikes the under-fives, and may lead to heart damage, and perhaps arthritis or meningitis.

The disease remains uncommon, with only 8.1 cases per 100,000 children in 2000, compared with 4.0 per 100,000 in 1991.

This rise has potentially very serious consequences as a fifth of children with untreated Kawasaki syndrome will develop cardiac lesions

Dr Anthony Harnden, University of Oxford

The cause is unknown, although there is evidence which suggests that it is caused, in a small minority of genetically susceptible children, by an infection.

Symptoms include high fevers, mood changes, red eyes, a swollen lymph node in the neck, swollen hands and feet and peeling skin on the fingers.

If caught early, anti-inflammatory treatment can be given, which reduces the chance of dangerous complications.
The rise mimics a similar increase in other countries - the incidence of the disease has risen by 50% in Japan between 1987 and 1998.

However, the overall rate varies widely from country to country.

Nine-year check

The researchers used NHS records to look for all hospital admissions from Kawasaki disease.

They found a total of more than 2,200 admissions over the nine-year period.

The majority were in the second half of this, after April 1995, and overall, there was a steady rise throughout the decade.

The researchers said that the rise could be due to a change in the infectious agent which might cause it - or in the susceptibility of young children.

However, they said it could also be due to a rising awareness of the condition, leading to an increase in correct diagnoses.

Vigilance call

One of the researchers, Dr Anthony Harnden, from the Department of Primary Health Care, at the University of Oxford said the rise had "potentially very serious consequences"

"A fifth of children with untreated Kawasaki syndrome will develop cardiac lesions during the acute phase of their illness, increasing their chances of developing heart problems later on in life," he said.

Dr Aziz Sheikh, from Imperial College London, at Charing Cross Hospital, adds: "Despite a heightened awareness of the disease over the past 10 years, this has not proven to be enough.

"More early diagnosis is needed, so the disease can be treated more effectively."